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What are the symptoms of Zika virus disease?
The manifestations are usually fairly trivial and similar to other viral infections, with moderate fever, rash with or without itching, conjunctivitis, muscle and joint pain, fatigue, headache. These signs appear within 3 to 12 days after the bite; they are in the great majority of the mild cases, and disappear in 2 to 7 days. It is estimated that 70 and 80% of Zika virus attacks do not give rise to any symptoms and go completely unnoticed.
People living in an epidemic area or who have been back for a dozen days and showing at least two of these signs should see their doctor, especially if it is a pregnant woman.
How is the diagnosis made?
The diagnosis is made either by isolating the virus in a blood or urine sample, or by looking for antibodies directed against this virus. In the presence of clinical signs, if the virus could not be identified, a serological examination (search for anti-zika antibodies) is requested. In France, only the National Reference Center for Arboviruses in Marseille is capable of detecting specific antibodies to the Zika virus.
How does the disease progress? Its complications?
The majority of Zika cases (80%) do not cause symptoms, and when they do appear they are mostly mild and go away within a few days. No death has been observed to date.
However, previous epidemics have shown that the Zika virus could cause neurological damage such as Guillain-Barré syndrome, damage to the peripheral nerves responsible for muscle weakness and tingling in the arms and legs. It and will heal in most cases although some weakness may persist in some people. It exceptionally gives serious complications when it reaches the respiratory muscles and requires hospitalization. Even in severe forms, no deaths have been observed there either.
The main fear associated with the Zika virus is the risk of microcephaly affecting the children of infected women during their pregnancy. Microcephaly is defined as a significant decrease in the size of a child’s head and is associated with abnormal brain development during womb or early childhood. The link between microcephaly and Zika is not yet fully explained.
What attitude during pregnancy? In France, when a Zika virus infection is confirmed in a pregnant woman, amniocentesis is not systematic, but it is recommended to perform an ultrasound every month, preferably in an antenatal diagnostic center. At birth, the cord blood, urine and placenta will be tested for the virus, as well as for the presence of antibodies. When the ultrasound shows abnormalities in the fetus (microcephaly, growth retardation), the mother should be referred to a multidisciplinary prenatal diagnosis center to specify the cause of the malformations (which may have other origins, infectious or not) and assessment of the risks to the unborn child. |